MR. PHILLIP DOUGLAS CLARK SR.
NPI 1053912451
Home Health Aide in Longs, SC

Q: What is Phillip Clark's NPI number?

The NPI number for Phillip Clark is 1053912451. It was assigned to this individual provider in the NPPES registry on November 3, 2020.

Q: What is Phillip Clark's specialty?

The primary specialty registered for this NPI is Home Health Aide with taxonomy code 374U00000X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Clark was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2020

2126 HIGHWAY 9 E UNIT 5B, LONGS, SC 29568(843) 353-8664(843) 485-0047 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Phillip Douglas Clark Sr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PHILLIP DOUGLAS CLARK SR. (NPI 1053912451) is an individual home health aide in Longs, South Carolina, licensed in South Carolina (1264) and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1053912451

Entity TypeIndividualMale

Primary Taxonomy374U00000X

Provider Legal NameMR. PHILLIP DOUGLAS CLARK SR.

Location Address2126 HIGHWAY 9 E UNIT 5BLongs, SC 29568-5725

Mailing Address3988 Tybre CtLittle River, SC 29566-8483 · (843) 353-8664

Phone(843) 353-8664

Fax(843) 485-0047

Sole ProprietorNo

Enumeration DateNovember 3, 2020

NPPES CertifiedNovember 3, 2020

✔ NPI 1053912451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome Health AideNursing Service Related Providers

Taxonomy Code374U00000X

Licenses✔ Licensed in SC · 1264✔ Licensed · 1264

Definition

A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.

2126 HIGHWAY 9 E UNIT 5B, Longs, SC 29568

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Other Identifiers 1

Other104613648SC · Driver License

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIDGING THE GAP WELLNESS CENTER LLC

Clinic/Center (Mental Health (Including Community Mental Health Center))

2126 HIGHWAY 9 E UNIT 5B
LONGS, SC 29568

Horry County (478) 361-2126

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip Clark's NPI number?

The NPI number for Phillip Clark is 1053912451. It was assigned to this individual provider in the NPPES registry on November 3, 2020.

Where is Phillip Clark located?

Phillip Clark practices at 2126 Highway 9 E Unit 5B, Longs, SC 29568. The listed phone number is (843) 353-8664.

What is Phillip Clark's specialty?

The primary specialty registered for this NPI is Home Health Aide with taxonomy code 374U00000X.

When was this NPI record last updated?

The NPPES record for Phillip Clark was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.